Pediatric EKG Tuesday Noon Teaching Session Developed by Dr. Lisa Lemieux Original slides courtesy...
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Transcript of Pediatric EKG Tuesday Noon Teaching Session Developed by Dr. Lisa Lemieux Original slides courtesy...
Pediatric EKGPediatric EKGTuesday Noon Teaching SessionDeveloped by Dr. Lisa Lemieux
Original slides courtesy of Dr. Lindsay Long(adapted)
Tuesday Noon Teaching SessionDeveloped by Dr. Lisa Lemieux
Original slides courtesy of Dr. Lindsay Long(adapted)
Approach to EKG interpretation:
Rate Rhythm
AxisIntervals
Ups and Downs
Approach to EKG interpretation:
Rate Rhythm
AxisIntervals
Ups and Downs
What are some challenges to interpreting Pediatric
EKG’s?
• age-related changes -- such as?
• movement artifact
Rate
Dubin, D. Rapid Interpretation of EKG’s. 6th Edition. Tampa, FL: Cover Publishing; 2000: 80-84.
Rate
Dubin, D. Rapid Interpretation of EKG’s. 6th Edition. Tampa, FL: Cover Publishing; 2000: 80-84.
Rate
Dubin, D. Rapid Interpretation of EKG’s. 6th Edition. Tampa, FL: Cover Publishing; 2000: 80-84.
Rate
Dubin, D. Rapid Interpretation of EKG’s. 6th Edition. Tampa, FL: Cover Publishing; 2000: 80-84.
Rate
Dubin, D. Rapid Interpretation of EKG’s. 6th Edition. Tampa, FL: Cover Publishing; 2000: 80-84.
Rate
Dubin, D. Rapid Interpretation of EKG’s. 6th Edition. Tampa, FL: Cover Publishing; 2000: 80-84.
Rate
Dubin, D. Rapid Interpretation of EKG’s. 6th Edition. Tampa, FL: Cover Publishing; 2000: 80-84.
Rhythm
• What defines a sinus rhythm? P wave before every QRS QRS after every P wave
‣ Normal PR interval for age Normal P wave axis Upright I and aVF
Rhythm
• What defines a sinus rhythm? P wave before every QRS QRS after every P wave Normal PR interval for age
Axis• QRS axis is usually directed
toward a hypertrophied ventricle
‣ What is the expected axis in a newborn?
Normal neonatal EKG in a 1-week-old infant. QRS axis is 125°, which would be considered right axis deviation in an adult. Note the tall R waves in V1, V2, and V3, which are normal.
O’Connor, M., McDaniel, N., Brady, W. The Pediatric Electrocardiogram Part I: Age-related Interpretation. American Journal of Emergency Medicine (2008) 26, 221–228
Learning Objectives
Basic Approach to Pediatric EKGs
• systematic approach
• refer to tables with age-related values
Rhythm recognition
How to use the EKG machine
Learning Objectives
Basic Approach to Pediatric EKGs
• systematic approach
• refer to tables with age-related values
Rhythm recognition
How to use the EKG machine
References• Chan, T., Sharieff, G., Brady, W. Electrocardiographic
Manifestations: Pediatric EKG. Journal of Emergency Medicine. 35(4):421–430
• Dubin, D. Rapid Interpretation of EKG’s. 6th Edition. Tampa, FL: Cover Publishing; 2000: 80-84.
• O ’Connor, M., McDaniel, N., Brady, W. The Pediatric Electrocardiogram Part I: Age-related Interpretation. American Journal of Emergency Medicine (2008) 26, 221–228
• Sharieff GQ, Rao SO. The pediatric EKG. Emerg Med. Clin North Am 2006;24:196.
• Pediatric Advanced Life Support, 2006 Edition.
• Wathen JE, Rewers AB, Yetman AT, et al. Accuracy of EKG interpretation in the pediatric emergency department. Ann Emerg Med. 2005;46:507-11.